Blue mode does not offer any benefit over white light when calculating Lewis score in small-bowel capsule endoscopy

AIM: To check the usefulness of blue mode (BM) review in lewis score (LS) calculation, by comparing it with respective LS results obtained by white light (WL) small-bowel capsule endoscopy (SBCE) review and mucosal inflammation as reflected by faecal calprotectin (FC) levels, considered as ’gold standard’ for this study. METHODS: Computational analysis of our SBCE database to identify patients who underwent SBCE with PillCam? and had FC measured within a 30-day period from their test. Only patients with prior colonoscopy were included, to exclude any colon pathology-associated FC rise. Each small bowel tertile was reviewed (viewing speed 8 fps) with WL and BM, in a back-to-back mode, by a single experienced reviewer. LS were calculated after each WL and BM reviews. Pearson rank correlation (rho, r) statistic was applied.RESULTS: Twenty-seven (n = 27, 20F/7M) patients were included. Thirteen (n = 13) had SBCE with PillCam?SB1, and the remainder (n = 14) with PillCam? SB2. The median level of FC in this cohort was 125 μg/g. LS (calculated in WL SBCE review) correlation with FC levels was r = 0.490 (P = 0.01), while for BM review and LS correlation with FC was r = 0.472 (P = 0.013).     

冠状动脉搭桥术早期并发症及死亡率(附196例报告)

1985年1月～1987年12月作者于荷兰格罗宁根医学科学院心胸外科主做了196例冠状动脉搭桥术。术后早期死亡2例(1.0％)、内出血3例(1.5％)、胸骨裂开2例(1.0％)、心律紊乱40例(20.4％)、围手术期心肌梗塞5例(2.6％),本文就术后早期并发症进行了讨论。     

Apports des explorations vasculaires ultrasonores à l''étude des néphropathies chez l''enfant

The proximity of child's kidneys from the cutaneous surface allows a particularly sensitive exploration by doppler sonography, which in addition has the major advantage of being a non-invasive, non-irradiating and painless technique. However there are two limitations to this technique: the lack of cooperation of some children and the still limited availability of high quality equipment in intensive care units. Indeed most of the applications described in this paper (ie. pyelonephritis, renovascular hypertension, tumors, acute renal insufficiency and renal vein thrombosis) require, besides an experienced operator, expensive power doppler equipment including high frequency and high resolution probes.     

Age, anemia, and obesity-associated oxygen desaturation during upper gastrointestinal endoscopy.

Although upper gastrointestinal endoscopy is generally a safe procedure, it is known to be associated with arterial oxygen desaturation. We studied 82 patients undergoing diagnostic upper gastrointestinal endoscopy following a standard premedication consisting of xylocaine throat spray and intravenous midazolam. The mean duration of endoscopy was 8.5 +/- 0.42 min and the mean dose of midazolam was 6.3 +/- 0.15 mg. The baseline SaO2 was 94.91 +/- 0.27% and it decreased after pre-medication to 92.84 +/- 0.40% (p < 0.001) and after intubation to 91.21 +/- 0.40% (p < 0.001). A fall greater than 4% saturation occurred for 15.68% of the total endoscopy time. SaO2 < 90% was seen for 16.7% and SaO2 < 85% occurred for 2.33% total endoscopy time. In patients > 65 years old, hemoglobin < 10 g/dl, or body mass index > 28, the baseline saturation was significantly lower and a reduced SaO2 was seen throughout the procedure. We identify old age, anemia, and obesity as independent risk factors for arterial oxygen desaturation. We recommend continuous monitoring before sedation, and giving supplemental oxygen to patients with these risk factors from the outset of upper gastrointestinal endoscopy.     

Cardiac tamponade in a preterm neonate secondary to a chest tube

In a preterm infant, chest tubes were inserted for treatment of bilateral pneumothoraces. Hemorrhagic pericardial effusion with cardiac tamponade developed, probably resulting from traumatic injury by the left chest tube. The infant survived due to timely diagnostic and therapeutic intervention. No recurrence of pericardial effusion was seen and follow-up showed normal psychomotor development.